| NPI | 1811996218 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207K00000X Allergy & Immunology (Licence: MI 4301073431) |
| Additional Taxonomies | 208000000X Pediatrics (Licence: MI 4301073431) |
| Enumeration Date | 2005-07-18 |
| Last Update Date | 2020-11-27 |